Abstract
Objectives
Several ligament balancing techniques for valgus total knee arthroplasty have been described. One of them is the sliding osteotomy of the lateral epicondyle described by Brilhault. This osteotomy releases the origins of the lateral collateral ligament and the popliteal tendon. According to the original description, the bone fragment is fixed with two screws after desired correction. The aim of this study is to determine the safety and feasibility of a simplified and non-fixed lateral epicondyle sliding osteotomy.
Methods
Retrospective case series of patients with valgus deformity who underwent total knee arthroplasty between 2006 and 2018. The main outcome was the incidence of complications and adverse events. Secondary outcomes were visual pain scale, Knee Society scale, varus stress test and varus knee thrust during gait. Limb alignment was also assessed with standing radiographs.
Results
22 participants (26 knees) were included in the study. There was no re-operation or early revision. The average follow-up was 4.5 years. Eighteen participants had no pain. Four participants had lateral knee pain (VAS pain = 4.5 ± 2.9). Last follow-up Knee Society Scale was 84.9 ± 6.7 ranging from 74 to 95. No participant presented varus instability. Radiographic alignment restored the limb's mechanical axis in all cases.
Conclusion
The simplified lateral epicondyle osteotomy procedure without fixation proved to be safe and effective.